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FSRH statement: number of women accessing services falls by 15% since 2014-15

We welcome NHS Digital’s publication of data on Sexual and Reproductive Health (SRH) care services in England for the year 2018-19. Nearly 800,000 women and girls accessed SRH services for contraception in 2018-19, a drop of 15% since 2014-15, when in-year cuts to the Public Health budget were introduced. The data indicates a concerning decrease in access to vital contraceptive services.

In comparison with the last period (2017/18), the number of women accessing SRH services for contraception decreased by 2%. The consequences of this ongoing decline are being reported by our members, who are experiencing cuts to specialist services as well as to the provision of long acting reversible methods in primary care. This is leaving the most vulnerable in our society and populations in rural areas under-served.

An even starker picture shows a marked decrease in access to emergency contraception. The number of women accessing SRH services for emergency contraception fell by 20% since 2014/15 and 5% in relation to the last period. In contrast, abortion rates have increased by 4% since 2017, and are now the highest number on record, an indication of mounting barriers for women to access contraception.

Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare (FSRH), said:

“Central Government’s cuts to Public Health budgets which started in 2015 have left local authorities struggling to find the right level of funding for these services.

"The data shows that women and girls appear to be finding it harder and harder to access essential contraceptive services, which is evidenced in worsening indicators in women’s reproductive health. Almost half of pregnancies in Britain are unplanned or ambivalent. Abortion rates for women over 30 have been steadily increasing for the last 10 years.

“The commitment to a real-terms increase to the Public Health budget in this year’s Spending Round is surely welcome, but it falls well short of the level of investment needed to restore services and meet increasing demand. We urge the Department of Health and Social Care to work with the Treasury to fully fund Public Health services in the next comprehensive Spending Review and call on Government to commit to restoring £1bn of real-terms cuts immediately.”

Ends

Notes to editors:

Around 39% of women in contact with SRH services for contraception were using oral contraception; 44% were using a long-acting reversible contraceptive (LARC) method such as the intrauterine device (IUD), the intrauterine system (IUS), the implant and the injectable. This is down from 41% and up from 42% respectively compared to the previous period.

In this publication, SRH services include family planning services, community contraception clinics, integrated Genitourinary Medicine (GUM) and SRH services as well as young people’s services e.g. Brook advisory centres. Data from GP settings and pharmacies is only included in data about prescriptions written by GPs and non-medical prescribers such as nurses, pharmacists and others). The NHS Digital data on Sexual and Reproductive Health Services, England - 2018/19 can be found here.

Freedom of Information (FOI) requests to all 152 upper tier local authorities in England last year found that almost half of councils in England have cut contraceptive services since the public health budget cuts in 2015. More than 8 million women of reproductive age are now living in an area where cuts to contraception budgets have taken place. The FOI audit by the Advisory Group on Contraception (AGC) can be found here.

According to data by the Department for Health and Social Care (DHSC), abortion rates to women aged 30-34 increased from 15.6 per 1,000 women in 2008 to 19.9 in 2018, and rates for women aged 35 and over increased from 6.7 per 1,000 women in 2008 to 9.2 per 1,000 women in 2018. DHSC’s report on abortion statistics in England and Wales for 2017 is available here.

FSRH has been calling for increased investment in contraceptive services and fully-funded Public Health services. In this climate of uncertainty, we support the call by The King’s Fund and the Health Foundation for the Government to commit to restoring £1bn of real-terms per head cuts to the public health grant immediately. Analysis by the two organisations can be found here. FSRH has also submitted evidence to the inquiry, by the Health and Social Care Committee, examining the funding required for NHS capital, education and training, social care and public health to implement the NHS Long Term Plan, which can be read here.

We have also endorsed a consensus statement by more than 80 health and local government organisations calling on the Government to increase investment in Public Health to prevent ill health, reduce health inequalities, and support a sustainable health and social care system. Read it here.

The Faculty of Sexual and Reproductive Healthcare (FSRH) is the largest UK professional membership organisation working at the heart of sexual and reproductive health (SRH), supporting healthcare professionals to deliver high quality care. It works with its 15,000 members, to shape sexual reproductive health for all. It produces evidence-based clinical guidance, standards, training, qualifications and research into SRH. It also delivers conferences and publishes the journal BMJ Sexual & Reproductive Health in partnership with the BMJ. For more information please visit: www.fsrh.org.

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About FSRH

FSRH is a faculty of the Royal College of the Obstetricians and Gynaecologists.
It was established on the 26th March 1993 as the Faculty of Family Planning and Reproductive Health Care.
Our specialist committees of SRH doctors and nurses work together to produce high quality training programmes,
specialist conferences and events, clinical guidance and other SRH learning resources